From Institutions to the Community: The Fundamor experience of transforming care for HIV-positive children and young people in Colombia


Fundamor, a renowned NGO that specialised in providing services for HIV-positive children, decided to try to close its institution and move children to family-based care. The institution had been established at a time when state support for HIV-positive people was in its infancy. Insufficient access to adequate health care, coupled with poverty, led parents of HIV-positive children to bring them to the Fundamor institution. Over time, the leadership of Fundamor noticed that whilst children received good health care, nutrition and education, they were not developing as they would in a family environment. Fundamor became concerned about the children’s independence and ability to cope in the community once they left the institution.

Fundamor sought out a range of partners and, with training, guidance and funding from Lumos, it embarked on a process of transforming care. Since 2015, Fundamor has worked in partnership with Lumos to ensure the care transformation process is carried out thoughtfully, striving at all times to ensure each child’s best interests were met.

This report documents that process, drawing out successes and challenges.

Fundamor discussed its plans with the Colombian Family Welfare Institute (ICBF), the government department responsible for children in care, who did not yet have resources to lead care transformation across the country. ICBF did, however, endorse Fundamor’s care transformation programme, and supported the process in whatever way it could.

Overall, the care transformation was a success, with most children placed in sustainable family environments that met their needs and improved their quality of life and inclusion in society. However, the process of transforming care is not without risk. To ensure all children are safe and their rights are respected, every decision must focus on the child’s best interest. Each element of the process must be carefully planned and costed, and resources found, to ensure good outcomes for children and long-term sustainability of any new services established. Placing children from Fundamor into families also required ensuring they would continue to access the health care they needed to survive and thrive.

Read the Spanish version here.